title: [Duplex ultrasound detection of type II endoleaks by after endovascular aneurysm repair: interest of contrast enhancement].
abstract: OBJECTIVE
  Type II endoleaks (EFII) are related to retrograde flow via aorta tributaries. They are the most frequent complication after endovascular aneurysm repair (EVAR). We hypothesized that the use of contrast-enhanced ultrasound (CEUS) by an experienced vascular physician could increase the sensitivity of detecting EFII compared with computed tomography angiography (CTA) taken as the gold standard.
  
  
  METHODS
  From November 2010 to February 2013, patients with EVAR were included prospectively. All patients had a color duplex ultrasound (CDU), CEUS and CTA. Sensitivity, specificity and kappa's coefficient were determined to estimate the performance of CDU and CEUS to assess EFII compared with CTA.
  
  
  RESULTS
  Sixty CDU and 60 CEUS explorations were compared to 60 CTA explorations. Nineteen type EFII were detected by CTA, 14 by CDU and 15 by CEUS. CDU sensitivity was 74% (κ=0.75), and CEUS sensitivity was 78% (κ=0.8). Both tests exhibited 97% specificity. There was good agreement between CDU results (κ=0.75) and CEUS results (κ=0.8) compared with CTA. There was very good agreement between CDU and CEUS results for detection of EFII (κ=0.93). There was no statistically significant difference between the sensitivity of CDU and CEUS (P=0.32).
  
  
  CONCLUSIONS
  Our results suggest that contrast enhancement does not increase yield for ultrasound detection of type II endoleaks when performed by an experienced vascular physician.
authors.affiliation: Service d'explorations fonctionnelles vasculaires et cardiaques, hôpital Édouard-Herriot, pavillon M, 5, place d'Arsonval, 69437 Lyon cedex 03, France. Electronic address: costa.patricia1@yahoo.fr.
authors.forename: P
authors.initials: P
authors.lastname: Costa
authors.forename: P
authors.initials: P
authors.lastname: Bureau Du Colombier
authors.forename: P
authors.initials: P
authors.lastname: Lermusiaux
mesh_terms: D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001027:Aortography / Q000379:methods; D057867:Endoleak / Q000000981:diagnostic imaging* / Q000209:etiology*; D057510:Endovascular Procedures / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D018616:Ultrasonography, Doppler, Duplex
keywords: Abdominal aorta aneurysm; Agent de contraste; Anévrysme de l’aorte abdominale; Computed tomography; Contrast-enhanced ultrasound; Duplex ultrasound; Endoprothèse aortique; Endovascular aneurysm repair; Tomodensitométrie; Échographie-doppler